Current status of anticoagulant treatments and improvements for hemodialysis patients in northern Chinese cities: a five-year comparative study
查看参考文献16篇
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文摘
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Background Anticoagulation treatments are an important aspect of hemodialysis; however, few reports have addressed these treatments. This investigation intends to increase the understanding of the current status and improvements of hemodialysis-related anticoagulation treatments in China. Methods In this study, an epidemiological investigation was conducted that examined 842 patients in 2007 and 1 175 patients in 2012 who underwent hemodialysis anticoagulation treatments in seven blood purification centers in northern Chinese cities. Results Heparin was the most commonly used anticoagulant, although the percentage of use of low-molecular-weight heparin (LMWH) increased from 26.5% in 2007 to 42.1% in 2012. In 2007, there were no significant differences in anticoagulant selection among either patients with various primary diseases or patients with hemorrhage, thrombosis, thrombocytopenia, or a low hemoglobin level. However, compared with patients with other diseases, significantly lower doses of LMWH were administered to patients with hypertension (55.5 U/kg vs. 67.3 U/kg, P <0.05) or diabetes (58.5 U/kg vs. 67.3 U/kg, P <0.05), and patients with hemorrhage received lower doses of heparin than the other patients (61.6 U/kg vs. 71.8 U/kg, P <0.01). In 2012, patients with diabetic nephropathy (51.5% vs. 36.5%, P <0.01), hemorrhage (43.4% vs. 31.7%, P <0.01), or a hemoglobin level below 90 g/L (57.2% vs. 37.1%, P <0.01) experienced significantly higher doses of LMWH administration; patients with hemorrhage received significantly reduced LMWH dosages (50.4 U/kg vs. 57.8 U/kg, P <0.05), and patients with thrombosis received significantly higher doses of heparin (73.8 U/kg vs. 62.1 U/kg, P <0.01) or LMWH (57.8 U/kg vs. 52.6 U/kg, P <0.05). Antiplatelet drugs were administered to 20.4% of the examined patients in 2007 and 20.7% in 2012. In 2012, patients with hypertension (25.9% vs. 18.5%, P <0.01) and thrombosis (36.6% vs. 16.1%, P <0.01) had a higher rate of using antiplatelet drugs than patients with other primary diseases and complications. Patients receiving antiplatelet drugs also received higher doses of heparin than patients without using antiplatelet drugs (74.4 U/kg vs. 65.9 U/kg, P <0.01). However, the use of the drugs was not correlated with thrombocytopenia. The rate at which coagulation indices were determined increased from 45.7% in 2007 to 64% in 2012. Conclusion These findings suggested that hemodialysis-related anticoagulation treatments in China have gradually become more standardized and individualized. |
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来源
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Chinese Medical Journal
,2014,127(16):2881-2887 【核心库】
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DOI
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10.3760/cma.j.issn.0366-6999.20140452
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关键词
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hemodialysis
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heparin
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low-molecular-weight heparin
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anticoagulant
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地址
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1.
Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology,National Clinical Research Center of Kidney Diseases, State Key Laboratory of Kidney Disease, Beijing, 100853
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Department of Nephrology, First Affiliated Hospital, Dalian Medical College, Liaoning, Dalian, 116023
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Department of Nephrology, General Hospital of the General Headquarters, Beijing, 100091
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Department of Nephrology, First Affiliated Hospital, Harbin Medical College, Heilongjiang, Harbin, 150081
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Department of Nephrology, First Affiliated Hospital, Chinese Medical University, Liaoning, Shenyang, 110001
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Department of Nephrology, First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing, 100048
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语种
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英文 |
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文献类型
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研究性论文 |
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ISSN
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0366-6999 |
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学科
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内科学;外国民族医学 |
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基金
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supported by the grants from the Major State Basic Research Development Program of China
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National Natural Science Foundation of China (No. 81270819), National Key Technology R&D Program
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Health Industry Scientific Research Special Project
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文献收藏号
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CSCD:5214081
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